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Abstract PURPOSE: To evaluate the accuracy of a new method of intraocular lens (IOL) power calculation for eyes having cataract extraction after previous laser in situ keratomileusis (LASIK). SETTING: Clinical private practice and ambulatory surgical center, Astoria, New York, USA. METHODS: This retrospective study was of 12 eyes of 9 patients who presented for cataract extraction after previous LASIK. Cataract removal was performed under topical anesthesia without IOL implantation. Approximately 30 minutes later, a manifest aphakic refraction was performed. The calculation of the IOL power was obtained by using an algorithm derived from previous experience with secondary IOL implantation (Mackool algorithm). The patient then returned to the operating room for lens implantation (aphakic refraction technique). RESULTS: The refractive error 2 weeks postoperatively, defined as the difference between the intended and actual refractive outcome, ranged from 0.50 diopter (D) of unintended hyperopia to 0.75 (D) of unintended myopia. CONCLUSIONS: The aphakic refraction technique provided an extremely accurate postoperative refraction in eyes having cataract with IOL implantation surgery after previous LASIK. Although the pool sample was small (12 eyes) and the range of the aphakic refraction was limited (+8.50 to 12.375 D), the technique was found to be remarkably accurate.